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<h3>Background</h3> Heart Failure affects more than 64 million people worldwide. Despite awareness that the symptom burden and morbidity associated with a heart failure diagnosis is significant, integration of palliative and cardiology services is uncommon. There is evidence that integration of services results in better symptom control and quality of life, and reduced hospital admissions and healthcare costs. <h3>Aim</h3> To develop a Supportive Palliative and Heart Failure service for patients with end stage heart failure who are identified as potentially being in the last year of life or whom have uncontrolled symptoms as a result of their illness. What was done 1. Development of monthly MDM a. Membership included;- Cardiology and Palliative Medicine Physicians, Specialist Heart Failure and Palliative nurses, Community palliative nurses, Community Allied Health Professionals, Specialist Palliative Pharmacist b. Discussion included;- advance care planning, symptom control assessment and optimisation of medical management of heart failure 2. Development of joint Supportive Heart Failure clinic a. Monthly clinic with joint review with cardiologist and palliative physician – 39 consultations over five month period. b. Discussion included;- Symptom and medical assessment, advance care planning 3. Pilot of Home Monitoring technology a. Currently 52 patients onboarded onto at home monitoring technology to allow remote monitoring of vital statistics and symptoms on a weekly basis. b. Early identification of deterioration, management of patients for whom repeated attendance at outpatient clinic is not appropriate <h3>Results</h3> Patient survey has reflected success in the service. • 80% of patients feel more connected to cardiology/palliative care team and feel more involved in healthcare decision making • 57.8% have reported improvements in their health • 98% of patients rate their experience with cardiology/palliative teams as excellent/good Collaboration with Queens University Belfast research departments will glean further results soon re: number of hospital admissions, length of stay, and health economic analysis <h3>Discussion</h3> With current pressures on all healthcare services, particularly those which are publicly funded, we must review how we deliver care. Preliminary data suggests that integration of services and collaboration across specialties improves the coordination of care and symptom control.